Table 1.
Demographics and clinical features of 13 consecutive acute ischemic stroke patients with COVID-19 infection.
| Patient | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Presenting symptoms (COVID vs. Neuro) | COVID | COVID | COVID | COVID | COVID | COVID | Neuro | Neuro | Neuro | Neuro | Neuro | Neuro | Neuro |
| Time of onset of neuro symptoms | (2 days) | (15 days) | (3 days) | (11 days) | (4 days) | (8 days) | |||||||
| Age range | 55–60 | 70–75 | 55–60 | 75–80 | 60–65 | 70–74 | 35–40 | 65–70 | 80–85 | 60–65 | 45–50 | 80–85 | 30–35 |
| Race/Ethnicity | AA | Other | Latino | Other | AA | AA | White | Latino | Latino | AA | Latino | Latino | Latino |
| Vascular risk factors | None | HTN, DM2, CAD | HTN, HLD, DM2 | HTN, Afib | HTN, Obesity | HTN, DM2 | DM2 | HTN, DM2 Obesity | DM2 | HTN, HLD, DM2, CAD | HTN, HLD, DM2 | HTN, HLD | None |
| Severity of COVID-19* | Regular | Severe/critical | Severe/critical | Severe/critical | Mild | Mild | Mild | Severe/critical | Severe/critical | Severe/critical | Severe/critical | Regular | Severe/critical |
| Admission GCS | 15 | 15 | 13 | 12 | 14 | 11 | 15 | 13 | 14 | 6 | 5 | 15 | 14 |
| NIHSS on admission | 2 | 2 | 23 | 6 | 3 | 23 | 4 | 26 | 4 | 28 | 22 | 13 | 11 |
| NIHSS on discharge or last NIHSS on exam | 2 | 4 | 13 | 14 | 2 | 18 | 6 | 3 | 28 | 19 | 35 | 0 | 16 |
| mRS on discharge or last mRS on exam | 2 | 3 | 4 | 5 | 2 | 3 | 4 | 3 | 6 | 4 | 6 | 0 | 4 |
| Stroke etiology | Cryptogenic | SW disease | Cryptogenic | Cardio-embolism (Afib) | Cardio-embolism (MI <4 weeks) | Large artery atherosclerosis (ICA) | Cryptogenic | Cryptogenic | Cryptogenic | Cardio-embolism (PFO with in situ DVT) | Large artery atherosclerosis (ICA) | Cryptogenic | Cryptogenic |
| ESUS | ESUS | ESUS | ESUS | ESUS | ESUS | ESUS | |||||||
| Stroke location | Cortical | Subcortical | Cortical | Cortical | Cortical | Cortical | Cortical | Cortical | Cortical | Cortical | Cortical | Cortical | Brainstem and cerebellum |
| Bilateral, multifocal | Left MCA | Left MCA | Right MCA | Right MCA | Right MCA | Left MCA | Left PCA | Left PCA, right MCA | Left PCA left MCA | Left MCA | Right MCA | ||
| Large vessel occlusion | No | No | Yes | No | Yes | Yes | Yes | No | No | No | Yes | No | No |
| Acute intervention | No | No | Thrombectomy/TICI2B | No | No | No | Thrombectomy/TICI2B | No | No | No | IV-tPAthrombectomy/TICI3 | IV-tPA | No |
| Systemic arterial or venous thrombosis | No | No | Arterial | No | No | No | No | No | No | Deep venous | No | No | Arterial |
| Disseminated intravascular coagulopathy | No | No | No | Yes | No | No | No | No | No | No | No | No | No |
| Therapeutic anticoagulation | None | None | Enoxaparin | Apixaban | None | None | Apixaban | None | None | Rivaroxaban | None | Coumadin | Enoxaparin |
| Antiplatelets | None | Aspirin | None | Aspirin | Ticagrelor aspirin | Aspirin | None | Aspirin | Aspirin | None | None | Clopidogrel | None |
| Discharge disposition | Home | Acute rehab | Acute rehab | LTAC | Home | Acute rehab | Acute rehab | Acute rehab | Expired | LTAC | Expired | Home | - |
Severity of COVID-19 infection was based on the 7th edition of “Novel Coronavirus pneumonia diagnosis and treatment plan” and the patients were divided into mild form (clinical symptoms are minor and imaging does not show any lung inflammation), regular (has fever and respiratory tract symptoms, imaging shows visible lung inflammation), severe (adults who have either shortness of breath, RR>30 breaths/min, SpO2 <93% at rest) and critical form (mechanical ventilation required or shock or combined failure of other organs that requires ICU monitoring) (10).
COVID-19, Coronavirus disease 19; F, Female; M(Male; AA, African-American; HTN, Hypertension; HLD, Hyperlipidemia; DM2, Diabetes mellitus type 2; CAD, coronary artery disease; GCS, Glasgow comma scale; NIHSS, National Institutes of Health Stroke Scale; mRS, modified Rankin scale; ESUS, Embolic stroke of unknown source; SW dis., Small vessel disease; MI, Myocardial infarction; ICA, Internal carotid artery; DVT, deep venous thrombosis; PFO, patent foramen ovale; MCA, middle cerebral artery; PCA, posterior cerebral artery; TICI, Thrombolysis in cerebral ischemia score; IV-tPA, intravenous-alteplase; LTAC, long-term acute care facility.